Book Review: Bad Science by Ben Goldacre

My list of Books I would force everyone to read if I were king of the world has a new entry. It is Bad Science by Ben Goldacre, which is also the name of his blog and column in the Guardian. A more accurate title would perhaps be Bad Medical Science, as Dr Goldacre is a GP and medical researcher, and apart from a few necessary deviations into statistics, most of the book concerns medical issues. As such, its appeal is limited to those who own and operate a human body. Here are a few highlights.

Ear candles are bunk. They claim to suction gunk out of your ear and into the candle. But they don’t produce any suction – we can measure that! – and the gunk inside the candle post-burning is there whether you burn the candle in your ear or not.

I’d never realised how much medical progress had been made so recently:

Before 1935 doctors were basically useless. We had morphine for pain relief – a drug with superficial charm, at least – and we could do operations fairly cleanly, although with huge doses of anaesthetics, because we hadn’t yet sorted out well-targeted muscle-relaxant drugs. Then suddenly, between about 1935 and 1975, science poured out an almost constant stream of miracle cures. If you got TB in the 1920s, you died, pale and emaciated, in the style of a romantic poet. If you got TB in the 1970s, then in all likelihood you would live to a ripe old age. You might have to take rifampicin and isoniazid for months on end, and they’re not nice drugs, and the side-effects will make your eyeballs and wee go pink, but if all goes well you will live to see inventions unimaginable in your childhood. … Almost everything we associate with modern medicine happened in that time: treatments like antibiotics, dialysis, transplants, intensive care, heart surgery, almost every drug you’ve ever heard of, and more. As well as the miracle treat ments, we really were finding those simple, direct, hidden killers that the media still pine for so desperately in their headlines.

Goldacre points out the remarkable differences between what vitamin salesmen say in their books – where they can say what they like – and what they say on the label on the bottle, which is subject to consumer legislation. For example:

The vitamin pill magnate Patrick Holford, for example, makes sweeping and dramatic claims for all kinds of supplements in his ‘Optimum Nutrition’ books; yet these same claims are not to be found on the labels of his own-brand ‘Optimum Nutrition’ range of vitamin pills (which do feature, however, a photograph of his face).

I did have a few reservations about this passage:

It’s only weird and startling when something very, very specific and unlikely happens if you have specifically predicted it beforehand.

There is some truth here, of course. But most of what we have learned in the last 100 years of physics and astronomy wasn’t predicted: quantum mechanics, superconductivity, quasars, pulsars, the acceleration of the universe, the menagerie of particles discovered by the first particle accelerators, neutrino masses. Goldacre isn’t making a mistake here, and clarifies a bit later: “If your hypothesis comes from analysing the data, then there is no sense in analysing the same data again to confirm it”. It’s just a rare overstatement in an otherwise admirably careful book.

Here, in case you ever need it, is the best summary of the way that scientists are viewed by the media you will ever need:

… science is portrayed as groundless, incomprehensible, didactic truth statements from scientists, who themselves are socially powerful, arbitrary, unelected authority figures. They are detached from reality; they do work that is either wacky or dangerous, but either way, everything in science is tenuous, contradictory, probably going to change soon and, most ridiculously, ‘hard to understand’. Having created this parody, the commentariat then attack it, as if they were genuinely critiquing what science is all about.

For example, the “scientist develops wacky equation to describe something menial” type of article that one sees from time to time are almost always sponsored by some company looking for a way to get their product mentioned in newspaper articles.

Finally, the most disturbing part of the book was the part that wasn’t in the first edition because Goldacre was being sued. It seems like anyone who devotes their time to testing dubious claims by quacks – Goldacre, Simon Singh, James Randi, Penn and Teller, anyone who mentions scientology – must then spend their time and several hundred thousand dollars defending libel suits. In Goldacre’s case, the accuser was Matthias Rath, who convinced much of South Africa to give up on HIV vaccines that could prevent the spread from mother to daughter, and instead buy his vitamin pills. Goldacre won, and published the relevant chapter of the book online. Even if you don’t buy the book, go read the free chapter. It is incredible and terrifying in equal measure. Seriously … go read it now.